Enhancing Anatomy Learning Through Mixed Reality-Supported Drawing: Investigating Learning Performance, Cognitive Load, and Intrinsic Motivation

Augmented Reality (AR) and Mixed Reality (MR) technologies present promising opportunities for enhancing anatomy education, for example by supporting learner-generated drawing tasks. This study investigated the impact of AR- and MR-supported drawing on drawing performance, learning outcomes, and the overall learning experience, in comparison to traditional instructor-guided drawing. A total of 73 medical students were randomly assigned to one of four conditions: traditional drawing (Control), AR-supported drawing, MR-supported drawing, and MR with stereoscopic 3D visualization. The results showed that both AR- and MR-supported drawing conditions effectively reduced extraneous cognitive load, enhanced intrinsic motivation, and improved drawing accuracy. However, no significant differences in knowledge acquisition were found across the four groups. Interestingly, in the stereoscopic 3D visualization condition, learners with higher intrinsic motivation demonstrated poorer learning performance. This suggests that their attention may have been diverted toward interacting with the system rather than focusing on conceptual understanding. Furthermore, visuospatial ability and prior knowledge moderated the effectiveness of AR/MR interventions, with more experienced learners gaining greater benefits. These findings underscore the importance of evaluating both learning performance and learner experience. They also emphasize the need to tailor AR/MR-based educational tools to individual learner characteristics in order to maximize their educational impact.